Healthcare Provider Details

I. General information

NPI: 1740015171
Provider Name (Legal Business Name): CAITLYN JEAN VENABLE WOLFF AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 TRENT DR
DURHAM NC
27710-3038
US

IV. Provider business mailing address

3306 PRIMROSE DR
NAVASSA NC
28451-5648
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-3786
  • Fax:
Mailing address:
  • Phone: 336-239-4891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number277619
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number277619
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: